Background: The Clarke Institute

Below is archived information about The Clarke Institute. In order to distance themselves from their checkered past, they have renamed themselves the Centre for Addiction and Mental Health.

Please click this link for updated information on the Centre for Addiction and Mental Health.


The Clarke Institute is a Toronto mental institution charged with serving gender-variant clients in the area. Under the direction of Ray Blanchard, it has become widely known as one of the most notorious facilities in the world in terms of controlling access to medical services.

According to their website they offer services, including for "those who wish to manage their cross-gender feelings and the expression of those feelings while remaining in their original gender role." This is another way to describe reparative therapy similar to groups who claim to "cure" gays and lesbians.

Much of the anti-trans thinking in the world today emanates from The Clarke, long nicknamed "Jurassic Clarke" in the trans community for its regressive policies.

The Clarke Institute is named after Charles Kirk Clarke (1857-1924). Clarke oversaw the two largest Canadian mental hospitals before accepting a government mental-health post. In addition to his desire “to keep this young country sane,” he sought to advance the psychiatric profession’s influence in making medical and political decisions.

Typical of “professionals” who are unable to see (or worse) unconcerned about larger systems which influence their realm of expertise or narrow interests, Clarke was an early proponent of eugenics, emphasizing the importance of restrictive laws that would limit the immigration and marriage of the “defective.” [2] During his tenure, foreign-born patients made up more than 50 percent of the institutionalized population in Canada. [3]

As Katherine Wilson notes:

Psychiatric diagnosis on the basis of social, cultural or political affiliation evokes the darkest memories of medical abuse in American history. For example, women suffragettes who demanded the right to vote in the early 1900s were diagnosed and institutionalized with a label of "hysteria" (Mayor, 1974). Immigrants, Bolsheviks and labor organizers of the same era were labeled as socially deviant and mentally defective by prominent psychiatric eugenicists, such as Dr. Charles Kirk Clarke. [4]

Christened with his name, the Clarke Institute of Psychiatry opened for business in 1966. A young staff member recalls those early days:

My first impression of psychiatry in Toronto was that it was rather parochial in outlook and had a distinct British socio-biological emphasis and little interest and much scepticism about psychoanalysis. […] The Clarke, instead of being an ivory tower, seemed more like a cold cement fortress. [5]

Some of the key players involved with the Clarke Institute are:

Ray Blanchard

Anne Lawrence

James Cantor

Meredith Chivers

Kenneth Zucker

Betty Steiner

Maxine Petersen

Susan Bradley

Kurt Freund

Michael Kuban

Commentaries on Blanchard

(05-04-2003) "Male gender dysphorics, paedophiles, and fetishists": How Ray Blanchard sees us

(01-19-2002) LINK: Autogynephilia: New Medical Thinking or Old Stereotype? (by Katherine Wilson, Ph.D.)

(05-06-2003) Ray Blanchard and the Clarke Institute: patient experiences

(07-01-1995) LINK: Access denied: TG healthcare in Ontario (by Ki Namaste, Ph.D.)

(07-01-2003) LINK: Clinician, Heal Thyself (report on James Cantor lecture) (via Trans-Health.com)

(07-01-2003) LINK: Much ado about Bailey (via Trans-Health.com)

(05-20-2003) My Experiences at the Clarke Institute (by Lesley Carter)

(05-18-2003) Lack of medical data in prestigious journals means sloppy work like Blanchard's goes unchallenged (By KS)

(04-23-2003) The Bailey Flap (by Ruth)

(10-03-2003) International Academy of Sex Research


My Experiences at the Clarke Institute

Editor's note: Leslie has graciously honored my request for submissions from women who had dealings with the Clarke Institute in Toronto. Leslie's story tells the sad tale of the Clarke's faded glory. Now that they do not hold any purse strings, they have no power to speak of over local transgender populations. Leslie found them to be "a bunch of dirty old men, masquerading as clowns... stuck in the 'ivory tower' mentality of an old, fossilized institution which has grown arrogant and believes it is above questioning."

"The Clarke" may have changed their name to Centre for Addiction and Mental Health (CAMH), but they remain as out of touch as ever with the patients they purport to help.

Thanks to Leslie for sharing her important story with such thoughtfulness and detail!

My Experiences with the Clarke Institute’s Gender Identity Clinic

First let me say that I did not have a bad time during my 4 visits to “the Clarke”. On the first occasion they were helpful; the second, polite and mildly complimentary; the third depressing because it was the support group full of depressed people and the last, just plain irrelevant.

I have always been a woman, but was in denial until September 2000. Once I admitted that my condition was gender dysphoria I had to do something about it. Three friends had been to the Clarke Clinic and I knew of no other place where the condition was dealt with. After almost a year of trying out herbals, which did nothing, I had a check-up with my family doctor and broached the subject. He readily agreed to refer me to the Clarke. That was in August 2001 and the appointment came up in April 2002.

During the intervening months four things happened. A friend offered me a bottle of Premarin and I eagerly began taking it on October 9, 2001. From a Yahoo group I found out about a doctor in Toronto who would prescribe hormones. He in turn found me a caring psychiatrist. I was forced out of my home by my family. So when I went to the Clarke it had already passed the time when I needed them for anything.

The biggest crisis in my life came on Valentine’s Day 2002. I was forced out of my home by my adult son, with my spouse’s agreement. They were extremely unhappy that I was “crossdressing” – never in front of them and never to the extent of interfering with my family’s welfare. They refused to consider any information I gave them and wouldn’t talk about it. Being ejected without warning was a total shock to me, and I looked around for help and support. The Clarke’s information package said they could help in a crisis, so I e-mailed and got an appointment with their only TS employee one week after my ouster.

First Contact

I had female clothes, but since the issue with my family seemed to be the clothing I wore, albeit always outside of the house, I stayed in self imposed male clothing for the first month of my separation from my family. I went to the appointment, February 21, 2002, dressed as a man, but still on hormones and still knowing I was a woman. I was received courteously by Ms Maxine Petersen and given ample time to tell my story. Her reaction, and that of everyone else, was that it was plainly wrong for this to have been done to me. I explained that the combination of my spouse and adult son against me made continuing to live there impossible. I was not about to get into a fist fight, something I had never been good at.

I remember asking if it was possible to be a transsexual and live as a man all or most of the time for the rest of my life. She said she didn’t know… which was a wise answer. We discussed an appointment for my spouse, but she said it would be better for her to see the social workers. Maxine felt unable to deal with irate wives herself. She told me my spouse would be able to come to my April evaluation days as long as I signed a release. While I passed this information on, I found that she had no wish to be involved in either way.

I felt affirmed and relieved that my personal understanding of my enforced leaving home was a sound interpretation. Of course, nothing further could be done to help me get back home without at least minimal cooperation from my spouse. Sadly, that was not forthcoming.

Second Contact

By the time my official evaluation came up I had seen my psychiatrist a couple of times and found him professional, caring and very helpful. He had counseled about 65 Trans patients during his long career. By this time I had given up hope of ever being re-united with my family and had transitioned to full time living as a woman, on March 13, 2002.

April 15 and 16, 2002, were my days at the Clarke. I didn’t know what to expect, and was prepared to walk away if I didn’t like what I found. I was pleasantly surprised. They no longer put sensors on the genital organs and show dirty pictures to test for gender dysphoria. That would have been sufficient for me to walk out…

First, I saw Maxine and was greeted warmly. I felt a lot more confident than at my last visit, as I was reconciled to probably losing my marriage, though not by my choice. I gave her my two photos as requested, “crossdressed” (actually neither was that as they both showed me as a woman), my questionnaire and my biography. We chatted for almost an hour and she rather apologetically asked me what turned out to be the key question at the gender clinic: “What do you think about when you are masturbating?” I told her. I was rather amused that they considered masturbation habits to be relevant to the diagnosis of gender identity.

My next interview was with Dr. Choy. He was also friendly and apart from saying with a smile that I had jumped 2 or 3 steps ahead of where I should be it was a pleasant experience. He also asked about my masturbation fantasies and I told him the same story.

Finally I was seen my Dr. Dickey, chief psychiatrist of the gender clinic. He was accompanied by his nurse, an older woman. He was very relaxed and gave me his opinion that gender dysphoria was a condition from birth. He also asked about my masturbation fantasies and I gave him the same answer. That was the most significant question I was ever asked, but clearly shows confusion between gender and sex. Or, perhaps an attempt to prove the validity of the autogynephilia theory of Dr. Ray Blanchard.

He asked me what I did about facial hair removal and I said I shaved. He advised me to start my electrolysis now. It wasn’t bad advice, but I didn’t have the money and they of course pay for nothing. It amused me that he felt he had to tell me that women don’t have facial hair! I was offered a piece of paper that he proposed was a “pretend ticket” for sexual re-assignment surgery and asked if I would take it. Of course the answer was yes – a no-risk, no-brainer decision since they didn’t fund it any more anyway. I guess I passed the test.

He asked me for any comments on their service to me and I had to mention that it had taken 7 months to get an appointment. He pulled a sad face and I sympathized that they had budget and staff cutbacks. He seemed glad to have the understanding and support from me… say, who was the therapist here?

In response to his inquiry as to any final questions I might have I asked this: “I don’t mean to be impolite, but can you tell me why I might ever want to come here again?” He took it well, thought a minute and came up with three possible reasons. First, if my psychiatrist didn’t work out they could provide that for me. Second, if I needed a letter for surgery, after a full two years of full time experience of course, they could do that for me, or provide the supporting letter. Third, I could attend their support group.

I had not heard the last item mentioned yet that day, but now it had become the “Jewell in the Crown”. I knew about it, so I said, “But, I can’t go there yet.” He seemed taken aback and said, “Of course you can go. You can go as a man; you can go as a woman; you can go dressed as a bunny rabbit!” While I was amused, and I think it was just his wacky but well meaning way of telling me that there was no dress code, it did make me wonder about this man. I later characterized them all as a bunch of dirty old men, masquerading as clowns!

After the hour the nurse walked me out to the locked door – this is a high security facility. She asked me if it was my own hair (no, I’m bald) and complimented me on my good taste in clothes (white blouse and tan knee-length skirt). She spoke rather distastefully of the “crossdressers” they sometime saw who dressed too flamboyantly.

The next day I was scheduled to see Dr. Betty Chan, Endocrinologist and Internist, at her office away from the Clarke. I say scheduled because even though the printed copy I had with me said 10, they had me down for 11 am. So I went and had a coffee first.

I had brought a photocopy of my latest blood test results, which she seemed glad to have. I was interviewed briefly about general health, and my HRT regimen. Then I was asked to strip down, in private, put on a paper dress and lie down for a physical examination. She was very discreet and gave me the same courtesy she gave all her female patients. She checked my blood pressure and said it was too high so I should ask my doctor to double my spironolactone and halve my Premarin. (The first my doctor agreed with and did, but he laughed and dismissed the second as typical of the Clarke’s extreme conservatism.) When I was about to leave I asked for my blood test results back and she seemed a bit taken aback that I wanted them, but photocopied them and returned my copy. She told me I didn’t need to come back, which was good as I had no need or intent to return anyway! To be fair to her, I should mention that she had a cold and was probably not feeling well.

The months went by and I was busy moving and re-establishing myself as a woman, in my new community. I knew the support group didn’t meet in July and August, and I had nothing back from the evaluation days. I e-mailed Maxine on May 14, 2002, asking about both and received no answer until late July. She told me then that she had been very ill and off work, which I sympathized with in my return mail. The recommendations following from the evaluation had not been sent out during her time off to recuperate, but she said they were the standard ones: continue transition; be under medical supervision for HRT; wait full 2 years before surgery. She gave me the date of the first support group meeting, and I resolved to attend it.

Third Contact

Wednesday September 18th, 2002, at 6 pm I went up to the 4th floor of the CAMH building and found over a dozen people waiting to be let in behind the locked door for the first meeting of the season. All were male to female types. One of them I knew already and said hello to her. I wore women’s cargo pants and a top and most were similarly dressed. A couple wore skirts and blouses, conservative and tasteful. Many made no attempt to look like women. Some looked scared.

We were taken to a crowded room which had about 18 chairs, for 16 of us. There was no coffee or other refreshments. We were asked to sign a confidentiality agreement. Nothing that took place in that room was ever to be revealed outside or we would be banned! Was I joining a secret society? I could understand that since this group was open to every variety of crossdresser, transgender and transsexual, privacy was important for some. Maxine was in attendance, but said little. She introduced a student who was really to be in charge, a nice young woman who was pleasant, but detached. I had the feeling that the prevailing atmosphere was, “We know you aren’t really women, and you know it too, but we will all pretend so you can feel good about yourselves.” I didn’t feel good. I knew I was a woman and found them condescending and oppressive.

We went around the circle introducing ourselves. There were 2 or 3 post-ops but most had not transitioned yet. Some were depressed, some hostile, some paranoid. I felt uncomfortable as I had none of these problems. My intro was brief and to the point: hormones begun October 9, 2001, transitioned March 13, 2002, surgery scheduled November 21, 2002. Most of the people told stories of doom and gloom. Problems in women’s washrooms, hair removal that hadn’t worked, rejection by families, severe depression not fully responding to treatment…

I told my little story about the two Pentecostal evangelist ladies who had visited me a few weeks before and didn’t understand what I meant when I said I wouldn’t be acceptable in their church because of my “gender dysphoria”. I’d had to say something to enlighten them, so I made the explanation that “I used to think I was a man, but I haven’t had any surgery yet.” They immediately told me that I should remain the way God made me and not do anything to alter my body. They took my hands and prayed for me very movingly, always using “her” and “she”. I had initially marveled that these were so untypical of many Christians who criticize and ridicule transsexuals. It struck me several hours later that they were convinced I was a genetic female who had at one time been tempted to masculinize myself!

I made the point that while I have a very femme body and pass easily, I believed that the most important ingredient was confidence. It could have happened to any one of them if they just believed in themselves. A few people were impressed favourably. Most just sat there... they preferred to tell their sad takes of woe and receive sympathy. The leaders did very little to guide the discussion or give helpful advice to anyone. They looked bored. They told one woman that she transitioned backwards because she did it at work before she transitioned at home. I felt sad for her. It wasn’t a confidence builder. I felt very much out of place. I’d gone into every possible situation before and since my transition and felt completely at home, but I wanted to get out of this artificial and stultifying place. When it was announced that our time was up at 7:30 pm I was glad to get out of there, and never went back. They had nothing to offer me. If I went weekly I would have been depressed!

A long time Clarke girl told me later that the Clarke’s method was to deliberately intimidate, so you would be able to stand up to the scorn and ridicule of the outside world. I found that strange as the outside world was a very comfortable place for me to live and be at ease in. Only the contrived Clarke atmosphere was hard to take. There is such a thing as anticipating trouble, so that it becomes a self-fulfilling prophesy… I think they do their clients no favours by this “programme”.

Fourth Contact

I was expecting a 6-month recall interview and sure enough, a week before I went to Thailand for my surgery the envelope arrived. It had been sent to my old address in Bowmanville. I checked, and I had advised the Clarke of my current address in August. More surprises ahead! Inside, the letter said, “Dear Andrew”, which was never a name I owned or used. Furthermore, the date of my appointment was to be November 20, the day before my surgery, when I would already be in Thailand. I had mentioned that at the support group, but obviously it hadn’t made it into the system.

I phoned and left a message explaining why I wasn’t going to make it on that date on their voice-mail, then e-mailed and cc’d to Maxine. Within 20 minutes I had a reply, apologizing profusely and thanking me for my “generous offer” to keep in touch after my surgery. Since it was worded so winningly I decided that I would contact them on my return, once I felt up to it.

You can read my surgery story at http://www.kindredspiritlakeside.homestead.com/lesley.html .

In early February I e-mailed Maxine and said that I was ready have the interview. She asked me to come in on February 28, 2003. I told her I was the biggest success story she would ever have sitting in her office. I showed her my psychiatrist’s letter to my surgeon, and my surgery photos. I offered to e-mail them to her, and did so at her request. She was interested in my psychiatrist and said she would invite him to join their new advisory committee. I told her I knew about it, but I wasn’t interested in applying to join the committee.

I discussed “what the Clarke could do for people” and asked why they doubled the Harry Benjamin standards. She told me about a few F to M TS’s who had dropped out of the programme and come back years later to thank her for not giving them hormones and thereby causing permanent sterility within months. That was the basis of their “higher” standards. I mentioned that a few handouts would really help clients: steps in transitioning; friendly electrologists; legal name change etc. She agreed it was a good idea. But after over 25 years in the business of “helping” Trans people they had nothing to give them.

Maxine was surprised to hear that the SRS surgeons in Thailand don’t follow the Harry Benjamin Standards. I was surprised that she was so unaware of that fact, and that many hundreds of people from all around the world prefer to go half way around the world rather than submit to the humiliation of the treatment gender clinics like the Clarke mete out.

I told her I try to steer as many people as possible away from the Clarke and to my own doctors, who give excellent service. She just shrugged. In light of their meager resources and diminishing budget I asked if I could volunteer and help them in some way. She said no, the only possibility was the advisory committee. I suggested that since they were not my support group I thought they should at least pay for parking, since I was aiding in their research. I was frostily told that they never did that.

So we didn’t part on the friendliest of terms, which was not my intention. She is a nice woman and as helpful as she can be within the restrictions the institution places on its staff. It seems the idea of being responsible to their clients is offensive to them. They are stuck in the “ivory tower” mentality of an old, fossilized institution which has grown arrogant and believes it is above questioning.

In Conclusion…

When they were the gatekeepers for government funded SRS they had great power. Now they are irrelevant, but still keep on in the same authoritarian way. Perhaps it is a good thing to have them to care (?) for those with serious co-morbid conditions beside gender dysphoria. It seems that many in the “support group” have fallen through the cracks of the health care system and they at least have something there. I know several people personally who went away from the Clarke weeping, yet found help elsewhere. There is no way of knowing for sure, but I believe the number may be quite high. They are success stories in the Clarke’s book, because they left the programme voluntarily and didn’t make the “mistake” of transitioning and SRS. At least the Clarke interprets it this way as they have lost touch with them. I’m told some former clients have committed suicide in despair of ever getting help, but I can’t verify that.

Would I go back if invited? Probably, but they won’t like the questions I ask and I doubt if I will hear from them again. I am not going to be put onto their committee and thereby neutralized as a critic of their practices and policies. It’s too bad they are so insular as they are the only “official” gender clinic in the province of Ontario. This means that every doctor has them in his reference book, and will send patients with gender issues only to them, unless they have specifically asked for another doctor.

I got what I wanted and needed without any help from the Clarke. It felt pretty good that I had gone through the evaluation and was treated with courtesy and compliments. It’s easy for me to “blend in” with feminine features and only 5’8” tall, but I wonder, do the big, angular girls have such a good experience from the Clarke?

Maxine did admit grudgingly that “maybe” I was one of the ones who didn’t need a full 2 year “real life test”. I’m told she took more like 5 years to make up her own mind. I knew after a week that this was the only life for me. I resent the fact that these people deliberately hold back very promising candidates for hormones and surgery just because they won’t treat them as individuals. It’s a “one size fits all approach” but we are not all the same! They don’t trust us to tell the truth about our transition dates. You have to change your name to an unmistakably female name (mine wouldn’t do) and show education receipts or pay stubs to prove you have lived it. Apparently “Big Brother” knows best… in their book.

I was 3 months on hormones before I found my hormone doctor and only 5 months full time before my psychiatrist recommended me for surgery. That would be considered irresponsible by the Clarke, but for me it was appropriate and worked. I like the way my psychiatrist put it better: “Any nurse, or secretary, can go down a check list and tell you when you have qualified for hormones or surgery. I assess you on the basis of my 23 years of working with trans clients and you are a classical transsexual.” I would never have heard that kind of statement at the Clarke.

My surgery experience is posted at http://www.kindredspiritlakeside.homestead.com/Leslie.html

Sincerely and lovingly,
Lesley Carter

Lesleycarter2000@yahoo.com

Update – November 2005

I’m now 3 years post-op and living a happy and anonymous life in the community with my partner. I accompanied her just a year ago to the same SRS surgeon I used and her results have been equally good. I’ve had little contact with the CAMH Gender Clinic but sometimes talk to their clients.

One girl who went on their advisory board confided in me that they were still rigidly standing by their old principles and she doubted they would ever change. I had anticipated that. Another contacted me because she was due for an appointment and couldn’t get a reply back from them. She eventually did, and I had lunch with her in the CAMH Cafeteria. It’s a huge 12 story building with all sorts of addiction and mental health clinics. It might have been my imagination but I thought we got a lot more rude stares from passers by than I had in other restaurants.

My opinions of this venerable old institution have changed very little in the intervening years. I still think they do more harm than good, but in a time of penny pinching by the government perhaps that problem will solve itself. What we need is more private physicians and psychiatrists who will give proper care to those who wish to transition and the means of finding them easily. Too many doctors would rather not touch anything as controversial as feminizing transsexuals. Even the Clinics who do give care to transsexuals are notoriously conservative. One of them has a used needle disposal system in their patients’ washroom, with a notice that they operate a needle exchange. However, they still insist on a minimum 3 month wait after first contact before prescribing hormones and have turned some down. One candidate who was turned down for health reasons came to me for information. She has been happily on “offshore” hormones for 6 months with no ill effects and is planning on SRS next year. Why are hormones considered more dangerous than illegal injectable heroin?

Our provincial government is considering re-listing SRS as a surgery that is funded by our health care system, but moving painfully slowly in that direction. If they do I want 3 new standards built into the plan: 1) free choice of the preferred surgeon (with a reasonable maximum limit on the price of course), 2) approvals by nothing more restrictive than the Harry Benjamin Standards – http://www.hbigda.org/soc.htm , and 3) allocation of sufficient funds to clear the 7 year backlog and provide enough surgeries to meet the real needs, not the 10 a year that it averaged before. Not to be too much of a pessimist, but I have my doubts that they will ever actually pay for it again.

 


My experiences

by Sharon

In the mid 1970's, when I was in my early twenties, I sought the assistance of the Clarke Institute of Psychiatry's gender identity program.
The conflict between my gender identity and my sex arose at about age 9. By age 12, I had come to understand that I was in fact a girl, and that I needed to change my body to conform to the way I felt inside.

At about this time, the newspapers reported the first experimental organ transplants, and the enhancement of topless dancers' breasts using silicone injections, which led me to speculate whether or not the same methods could be used to make my body female.

Unfortunately, I was very tall for my age - already over 6 feet, and still growing rapidly. I knew that this would be great obstacle to passing as a woman, and it was a tremendous source of anxiety.

I needed to start shaving at a younger age than most boys I knew. Had I been a boy, this might have been a source of pride and self-confidence, but I was a girl, so it was hell.

At about age 13, I read a newspaper article about transsexualism, and the existence of endocrinological and surgical treatment. It was a great relief to know that I was not alone, and that medical treatment existed. Through my adolescence, I never wavered in my desire to be female in all respects.

The Clarke made clear from the outset that research was the major focus of their program. I was supportive of their conducting research, but I soon realized that they offered precious little in the way of treatment, and then only to the small fraction of applicants they accepted into their program.
They scheduled numerous appointments for all manner of tests and interviews. I was interviewed by at least two of their staff psychiatrists, including Dr. Freund, who tried to console me by pointing out that this problem was not my fault. I already knew that. The other psychiatrist focused a lot on my height, and pointed out that I would have a lot of problems, which of course, I already knew.

Several of my appointments were at nearby hospitals for various medical tests. I recall that one of them involved some sort of an imaging scan. I handed the test form to the technicians, one of whom giggled when she read on it "transsexual", Fortunately, all other medical professionals I encountered at the hospitals treated me with respect.

My assessment by an endocrinologist led to the one bright spot in my Clarke experience. He was new to their program, and I recall that they talked him up as being a leader in his field, and something of a coup to have on their team.

I found him understanding, and willing to help. As part of his assessment, he asked to see me completely in the nude, so that he could get a sense of what hormones might do for me. While acknowledging that my height was an obstacle, he expressed the opinion that my body could be successfully feminized using hormones. This was music to my ears!

Even better, he offered to start me on estrogen right away, and I was thrilled to accept. At my first opportunity the next day, I presented my prescription to a local pharmacist, but there was a set-back. I was told that they could not provide the prescribed dose. At first they refused to explain the problem, but eventually told me that the unit of measure was out by a factor of 1000, e.g. micrograms vs milligrams. Fortunately, they were able to reach the endocrinologist by phone and quickly resolved the problem, but it was a nervous moment.

It felt wonderful to start on hormones. Soon, I had a follow-up meeting with the endocrinologist, at which he asked me a favour - would I be willing to meet some of his medical students, to provide them an opportunity to meet someone like me. He wanted to include that experience in their training, in the hope of promoting better understanding. Recalling the giggles from the imaging technician, I could see the potential benefit, so I readily agreed. We had the meeting, and it went very well. Needless to say, I was feeling much better about the Clarke's program.

With the completion of the medical tests, my appointments reverted to the Clarke. As I recall, one of the staff asked how I liked their new endocrinologist. I responded very positively, and expressed my joy at finally having been prescribed estrogen. Upon hearing this, the staff member freaked, and next thing I knew, I was confronted by more senior staff, who told me that the endocrinologist had not been authorized to prescribe the hormones to me. They demanded that I turn over the unused portion of the drug, else they would drop me from their evaluation.

I felt I had no real choice in the matter, so I reluctantly complied. It was a huge let down, and from that point, the Clarke experience was just something to be endured.

One of their evaluations required that I present myself dressed as woman for an interview with one of their staff, which was to be videotaped. Since I had not transitioned, and would not have passed in public, they agreed that I could change into my feminine attire on the premises. They left me alone to change in the studio where the interview was to be taped, but soon I noticed the cameras slewing to aim at me. The bastards were taping me dressing! I complained, afterward, but they just sloughed it off. It was now becoming clear that I was much more of a test subject to them, than a human being.
One of the final tests involved the plethysmograph. A contraption designed to measure penile response while the subject is shown various pictures. I was told not to speak, and to focus my attention on the pictures. I was surprised to find that some of them were from the session for which I had dressed as a woman. I remember little else about the test itself.

Afterward, I chatted briefly with the test conductor, as we walked down the hall. Trying to make the best of the awkward situation, I commented that I guessed it was valuable to have the opportunity to obtain scientific data on transsexuals. To which he responded that few true transsexuals were available for study, in contrast with homosexuals, who were available "by the wheelbarrow". Clearly, I was just a data point to him.

Finally, I met with Dr. Steiner and several other of the staff, who told me, "You are not a transsexual, and you do not need a sex-change, at least not now." Dr. Steiner warned against rushing to feminize myself on hormones, because in her opinion that accounted for most of the sex-change. I was told that I required years of intensive psychotherapy, and they offered to recommend some doctors. I told them, "thank you for nothing", and walked out.
I was little more than a research subject to them - research that spawned such nonsense as Dr. Blanchard's theory of autogynephilia.

Within a year, I found a gynecologist who readily agreed to my request to begin hormone treatment. My body responded wonderfully to estrogen, and within two years, I had a pleasing bosom, and my hips had filled out - finally skirts fit properly! Having greater access to my female emotions was great, as was losing my male sex drive.

In the end, I found the prospect of transition too daunting. I was not at all confident that I could overcome the problems of my great height. I did not have the emotional strength to deal with the rejection of family, and the abuse of strangers. Living as a man is hell for a woman, but living as a woman seen by everyone as a man, likely would be even worse.

Nevertheless, I completed facial electrolysis, and I love the softness of my skin. My hair is shoulder length, femininely cut, and I love it! I have never for a moment regretted feminizing my body. After twenty five years, I could not imagine not having breasts. For me, some feminization has proven much better than none. It made my life bearable, though far from happy. Successful transition is the only way to have a chance at true happiness.

I am fortunate to have meaningful and intellectually stimulating hobbies, into which I can escape for brief periods. I am also fortunate to have a few good friends.

Sharon

--

Toronto Star, Tuesday, November 27, 1984
Trans-sexuals happier after operation, MD says
By Lillian Newbery
Toronto Star
Page H2

The vast majority of men and women who had surgical sex changes in Toronto say they prefer their new gender.
Most support themselves in society without welfare or unemployment insurance.

Dr. Mary Steiner, head of the Gender Disorder Clinic and the Clarke Institute of Psychiatry, said recently the favorable results probably reflect the strict evaluation given those who seek such surgery. Only 1 in 10 men who request it are approved.

The Gender Identity Clinic assesses individuals who dress as the opposite sex, long to be the opposite sex or believe that inside they really are the opposite sex, research co-ordinator Leonard Clemmensen said during a recent research open house at the institute on College St.

In the most extreme cases, called trans-sexuals, the sense of belonging to the opposite sex is “longstanding and unalterable” and leaves them feeling constantly unhappy.

“If the patient has been definitely diagnosed as trans-sexual, has no other major psychiatric disorder and has proven ability to function in society as a member of the opposite sex, then the clinic may recommend sex reassignment.”

The Gender Identity Clinic contacted 38 women who became men and 41 men who became women, representing 77.5 per cent of all sex reassignments coordinated through the provincial institute in the past 15 years.

The study included only people who had the surgery a year or more before and the average time between the date of surgery and follow-up was 47.4 months.

Only one of the group said she was “unsure” if she still wanted to live as a female and none said they wish they hadn’t had the sex change. All but five said they prefer their current gender and would undergo such surgery again. One homosexual male changed to a female, three heterosexual males changed to females and one female changed to a man said they would “probably” choose the change if they had the decision to make over again.

One of the aims of the program has always been to end up with people who are self-supporting in society, Steiner said. Usually they hold jobs on a lower level than before the sex change, although some have returned to their old jobs.

Of 79 studied, 69 sustain themselves in society without welfare or unemployment insurance benefits.

All the 38 women who underwent the sex change had been attracted to females before the surgery. Of the 41 men: 32 known as homosexual trans-sexuals had been attracted to other males before surgery; nine known as heterosexual trans-sexuals has been attracted to females.
Thirty-nine of the 79 live with a member of their own biological sex in a stable relationship.

If you had dealings with the Clarke Institute and the Gender Identity Program, particularly with Ray Blanchard, we hope you'll contact me to share your story.

References

2. Keeping America Sane: Psychiatry and Eugenics in the United States and Canada, 1880-1940. Ian Robert Dowbiggin. Cornell University Press, 1997.

3. www.americanscientist.org/bookshelf/Leads98/benjamin.html

4. http://www.transgender.org/tg/gidr/tf3023.html (citing Dowbiggin, 1997, pp. 133-177).

5. http://www.psychoanalysis.ca/clients/cps/essays/tps%20history.html